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Table 3 Outputs of the SHARE Program (Reproduced with permission from SHARE Paper 1 [44])

From: Sustainability in Health care by Allocating Resources Effectively (SHARE) 11: reporting outcomes of an evidence-driven approach to disinvestment in a local healthcare setting

Research questions Outputs
SHARE 2: Identifying opportunities for disinvestment in a local healthcare setting
 ▪ What concepts, definitions and perspectives underpin disinvestment?  ▪ What models or methods of disinvestment have been implemented in hospitals or health services?  ▪ Where are the opportunities for systematic decisions about disinvestment in a local health service network? ▪ Framework and detailed discussion of potential settings and methods for disinvestment in the local healthcare context ▪ Summary of issues to consider in development of an organisational program for disinvestment ▪ Interview protocol for ascertaining local implications for disinvestment
SHARE 3: Examining how resource allocation decisions are made, implemented and evaluated in a local healthcare setting
 ▪ Where, how and by whom are decisions about resource allocation made, implemented and evaluated at Monash Health?  ▪ What factors influence these processes?  ▪ What knowledge or experience of disinvestment exists within Monash Health? ▪ Framework of eight components in the research allocation process, the elements of structure and practice for each component, and the relationships between them ▪ Classification of decision-makers, decision-making settings, type and scope of decisions, strengths and weaknesses, barriers and enablers ▪ Examples of decision-making criteria and types and sources of evaluation data used ▪ Interview and workshop protocols for ascertaining local decision-making systems and processes
SHARE 4: Exploring opportunities and methods for consumer engagement in resource allocation in a local healthcare setting
 ▪ How can consumer and community values and preferences be systematically integrated into organisation-wide decision-making for resource allocation? ▪ Model for integrating consumer values and preferences into decision-making for resource allocation ▪ Definitions for consumer engagement terminology ▪ Examples of sources of consumer information and data ▪ Examples of consumer-related activities generating proactive decisions to drive change
SHARE 5: Developing a model for evidence-driven resource allocation in a local healthcare setting
 ▪ What are the implications for disinvestment at Monash Health?  ▪ What is the most appropriate and effective approach to organisation-wide, systematic, integrated, evidence-driven disinvestment at Monash Health?  ▪ Can a model for evidence-driven resource allocation in the local healthcare setting be derived from the Monash Health program to enable replication and testing? ▪ Model for exploring Sustainability in Health care by Allocating Resources Effectively in the local healthcare setting ▪ Definition of four program components, aims and objectives, relationships between components, principles that underpin the program, implementation and evaluation plans, and preconditions for success and sustainability. ▪ Summary of implications for disinvestment in the local setting and resulting decisions for program development ▪ Summary of factors for program sustainability ▪ Evaluation framework and plan
SHARE 6: Investigating methods to identify, prioritise, implement and evaluate disinvestment projects in a local healthcare setting
 ▪ What methods are available to identify potential disinvestment opportunities in a local health service?  ▪ What methods are available for prioritisation and decision-making to initiate disinvestment projects in a local health service?  ▪ What methods are available to develop, implement and evaluate disinvestment projects in a local health service?  ▪ What were the processes and outcomes of application of these methods at Monash Health?  ▪ What factors influenced the decisions, processes and outcomes? ▪ Framework for evaluation and explication of a disinvestment project ▪ Examples of criteria for selection of disinvestment projects ▪ Methods for developing an evidence-based catalogue of potential disinvestment opportunities ▪ Algorithm for selecting a disinvestment project from an evidence-based catalogue of potential disinvestment opportunities ▪ Summary of barriers and enablers to implementation and evaluation ▪ Summary of factors related to determinants of effectiveness arising in SHARE process and disinvestment projects
SHARE 7: Supporting staff in evidence-based decision-making, implementation and evaluation in a local healthcare setting
 ▪ What is current practice in accessing and using evidence for making, implementing and evaluating decisions at Monash Health?  ▪ What decisions were made and outcomes achieved in the piloting of support services?  ▪ What factors influenced the decisions, processes and outcomes? ▪ Matrix of barriers, enablers, additional needs and evidence-based interventions mapped to their corresponding components in four support services to enable evidence-based decision-making, implementation and evaluation ▪ Summary of factors influencing decision-making for development of support services ▪ Summary of factors influencing the outcomes of the SHARE support services piloting process ▪ Summaries of current practice, knowledge, skills, confidence and needs in finding, accessing and using evidence for making, implementing and evaluating decisions; and preferred formats for education and training ▪ Summaries of nature, type and availability of local health service data; data sources; uses and expertise available ▪ Evaluation framework and plan
SHARE 8: Developing, implementing and evaluating an Evidence Dissemination Service in a local healthcare setting
 ▪ What are the potential features of an Evidence Dissemination Service in a local healthcare setting?  ▪ How can high quality synthesised evidence be identified, captured, classified, stored, repackaged and disseminated?  ▪ How can disseminated evidence be used to enhance current practice and how can use of evidence be reported?  ▪ What are the processes and outcomes of disseminating evidence to self-selected and targeted participants in a voluntary framework?  ▪ What are the processes and outcomes of disseminating evidence to designated decision-makers in a mandatory governance framework?  ▪ What factors influenced the decisions, processes and outcomes? ▪ Two models for an Evidence Dissemination Service (EDS) in a local healthcare service ▪ Methods for identification, capture, classification, storage, repackaging and dissemination of evidence ▪ Methods to facilitate use of disseminated evidence and reporting of outcomes ▪ Taxonomy for categorising publications ▪ Framework for evaluation and explication of implementation of health information products and services ▪ Summaries of factors influencing decisions, processes and outcomes in development and delivery of the EDS
SHARE 9: Conceptualising disinvestment in a local healthcare setting
 ▪ Aims: To discuss the current literature on disinvestment from a conceptual perspective, consider the implications for local healthcare settings and propose a new definition and two potential approaches to disinvestment in this context to stimulate further research and discussion. ▪ Discussion of the disinvestment literature in relation to terminology and concepts, motivation and purpose, relationships with other health improvement paradigms, challenges, and implications for policy, practice and research in local healthcare settings
SHARE 10: Operationalising disinvestment in a conceptual framework for resource allocation
 ▪ Aims: To discuss the current literature on disinvestment from an operational perspective, combine it with the experiences of the SHARE Program, and propose a framework for disinvestment in the context of resource allocation in the local healthcare setting. ▪ Discussion of the disinvestment literature from an operational perspective in local healthcare settings ▪ Summary of theories, frameworks and models used in disinvestment-related activities ▪ Framework for evidence-based disinvestment in the context of resource allocation  - Standardised definitions and concepts to underpin framework  - Principles for resource allocation decision-making  - Potential activities and settings for disinvestment  - Potential prompts and triggers to initiate disinvestment decisions  - Methods and tools for disinvestment  - Barriers to disinvestment
SHARE 11: Reporting outcomes of an evidence-driven approach to disinvestment in a local healthcare setting
 ▪ Aims: To consolidate the findings, discuss the contribution of the SHARE Program to the knowledge and understanding of disinvestment in the local healthcare setting, and consider the implications for policy, practice and research. ▪ Summary of outcomes of the SHARE Program ▪ Key messages ▪ Implications for research, policy and practice
SHARE National Workshop
 ▪ Aim: To share knowledge of disinvestment and develop links for future collaborative work opportunities ▪ Summary of disinvestment activities from health policy, health economics and health service perspectives ▪ Tools for group activities discussing disinvestment concepts and decision-making ▪ Tools for individual activities to capture information about current practice and research in disinvestment ▪ Workshop presentations ▪ Workshop evaluation tool and findings ▪ Summary of key messages